Night eating disorder needs more study

NEW YORK (Reuters Health) - A fairly rare eating disorder
whose signature is excessive eating - though not necessarily
binging - at night needs further study since it may signal other
mental health issues, researchers say.

They analyzed eating disorders and mental health history in
more than 1,600 university students and found about 4 percent
met night eating disorder criteria, with about a third of those
also engaging in binge eating.

"Night eating syndrome is characterized not only by eating
at night - certainly many college students might have a late
night study fest with eating - but it's also characterized by
other things, like feeling that you can't eat in the morning,
and feeling like you have to eat in order to go back to sleep,"
Dr. Rebecka Peebles told Reuters Health.

Peebles, the study's senior author, is an attending
physician at the Children's Hospital of Philadelphia, and a
researcher in the department of Pediatrics at the Perelman
School of Medicine at the University of Pennsylvania.

"Our study helped extend findings of previous studies that
have not been controlling for binge eating," Peebles said. "We
know that binge eating and night eating have a pretty moderate
overlap so a lot of people who come into the clinic for night
eating often have binge eating."

"We think night eating is something to be aware of even
though it only occurs in just under 3 percent of the students
after controlling for binge eating, so it's still a pretty
important entity," Peebles said.

Distinguishing night eating from binge eating is important,
Peebles and her colleagues write in the Journal of Adolescent
Health, for several reasons. Night eating may require a
different treatment approach than other eating disorders, which
could also be present.

Night eating was also more common in students with a history
of anorexia nervosa and in students taking ADHD medications,
they report, so those other disorders may play a role in the
nighttime eating syndrome.

Night eating disorder is a distinct diagnosis in the newest
psychiatric Diagnostic and Statistical Manual (DSM-5), the
researchers note.

The syndrome is often characterized by increased appetite at
night, but usually takes the form of "grazing" on food all
evening, rather than intensive binging, and also may include
waking up in the night to eat.

Often the urge to eat is tied to the feeling it that it will
improve sleep or allow the person to get back to sleep.

The authors said that young adults tend to eat more at night
and college students who are stressed and have inconsistent
sleep patterns may be at risk for night eating.

But most previous research on the subject has been limited
to small groups and has failed to adjust for the overlap of
binge eating disorder among night eaters.

To get a sense of how common night eating disorder is and
what other traits or risk factors go along with it, the
researchers analyzed data from a large 2008 survey of students
in 10 U.S. universities.

A total of 1,636 students were included in the new analysis.
About 60 percent were young women and 74 percent were white.
About 60 percent of the students were also competitive athletes.

The online survey included information on height and weight,
plus four questionnaires focused on night eating, eating
disorders in general and health-related quality of life. Scores
on the Night Eating Questionnaire (NEQ) were used to diagnose
night eating disorder.

Binge eating was also measured by students' reports of
details such as a feeling of loss of control over eating.
Recurrent binge eating was defined as binge eating large amounts
of food at least four times during the previous month.

A total of 67 respondents (4.2 percent) met the criteria for
night eating syndrome. They were also more likely than other
students to have other eating-disorder behaviors such as
excessive laxative use, compulsive exercise and purging, as well
as lower quality of life. Another 222 students (14 percent)
appeared to be binge eaters.

Of the 67 students with night eating syndrome, 22 were also
binge eaters. Excluding the binge eaters from the group of
students with night eating syndrome reduced the prevalence of
night eating to 2.9 percent.

A history of depression and self-injuring was more common
among those with night eating disorder.

"I think it's important to know that it affects both men and
women and also all races and ethnicities," Cristin Runfola told
Reuters Health.

Runfola, a researcher with the University of North Carolina
Center for Excellence for Eating Disorders, led the study.

The study showed that night eating syndrome was also
associated with other eating disorder behaviors that could lead
to serious physical and psychological consequences, she said.

It's important that people with night eating syndrome get
help, Runfola said, adding that parents and friends can spot
signs of night eating in young adults.

"You might see fluctuations in weight or you might notice
food missing in the house," she said.

"Often times these people are eating throughout the night,"
she added. "They might even be waking up and feeding multiple
times throughout the night, so if you're frequently hearing that
someone's getting out of bed throughout the night and you're
noticing that food is missing there might be something going
on."